Vandenbrook, Amy Weatherwax

Vandenbrook, Amy Weatherwax is an individual health care provider with primary practice located at 145 Ogden Ave , Downers Grove IL 60515-2323. She recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as her primary health care specialty. Vandenbrook, Amy Weatherwax can be contacted via phone (630) 971-2020.

Contact Information

Primary practice address
145 Ogden Ave Downers Grove IL 60515-2323
Phone: (630) 971-2020
Fax: (630) 964-2211
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 036-104595 Illinois

Profile Details

NPI number 1760563639
LBN Legal business name Vandenbrook, Amy Weatherwax
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Oct 13th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760563639 NPPES
Illinois Other 001622078 BLUS CROSS BLUE SHEILD
Illinois MEDICAID 036104595 BLUS CROSS BLUE SHEILD

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